Drug-Induced Hematologic Disorders

First Things First (assess & treat for the following)

  • These side effects can occur in the marrow or systemically, and hematologic effects of drugs can be mediated by one or many factors.
  • Dysfunction can range in severity from mild to severe, and the clinical picture is variable.
  • Hemolysis is usually not severe, but life-threatening cases do occur, esp. in pts with comorbid conditions.
  • Some drug-induced disorders may occur weeks to years after use.
  • Suspect cephalosporin- or quinidine-induced hemolytic anemia if acute, severe hemolysis occurs with renal failure.
  • Diagnostic tests are not always specific; usually the diagnosis made with history, physical & removal of suspected drug.
  • Suspect drug-induced hemolytic anemia if:
    • Anemia, fevers, rash, renal failure develop when drug started
    • Hemolytic indices are seen:
      • Anemia, cytopenias
      • Reticulocytosis
      • Increased LDH
      • Decreased haptoglobin
    • Increased indirect bilirubin
    • Hemoglobinuria
  • Discontinue any new drug that may be responsible for a recent change in pt’s condition.

There's more to see -- the rest of this topic is available only to subscribers.

Last updated: May 10, 2010